Landfill management is a complex discipline, requiring very high levels of organisation, and considerable investment. Until the early 1990’s most Irish landfill sites were not managed to modern standards. Illegal landfill sites are, of course, usually not managed at all. Landfills are very active. The traditional idea of ‘put it in the ground and forget about it’ is entirely misleading. There is a lot of chemical and biological activity underground. This produces complex changes in the chemistry of the landfill, and of the emissions from the site. The main emissions of concern are landfill gases and contaminated water (which is known as leachate). Both of these emissions have complex and changing chemical compositions, and both depend critically on what has been put into the landfill. The gases spread mainly through the atmosphere, but also through the soil, while the leachate (the water) spreads through surface waters and the local groundwater. Essentially all unmanaged landfills will discharge large volumes of leachate into the local groundwater. In sites where the waste accepted has been properly regulated, and where no hazardous wastes are present, there is a lot known about the likely composition of this leachate and there is some knowledge of its likely biological and health effects. This is not the case for poorly regulated sites, where the composition of the waste accepted is unknown. It is possible to monitor the emissions from landfills, and to reduce some of the adverse health and environmental effects of these. These emissions, and hence the possible health effects, depend greatly on the content of the landfill, and on the details of the local geology and landscape. There is insufficient evidence to demonstrate a clear link between cancers and exposure to landfill, however, it is noted that there may be an association with adverse birth outcomes such as low birth weight and birth defects. It should be noted, however, that modern landfills, run in strict accordance with standard operation procedures, would have much less impact on the health of residents living in proximity to the site.